HomeMy WebLinkAboutDELEHOY - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE DELBH-1 OP ID L DATE(MMIDD/YYYY)
11 29 05
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown & Brown Inc - Ft Collins ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
125 S Howes, Sth Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P O Box 2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80522-2226
Phone:970-482-7747 Fax:970-484-4165 INSURERS AFFORDING COVERAGE NAIC#
INSURED
Delehoy Constrµction
3109 S. T#ft Hill Rd
Fort Collins CO 80526
COVERAGES
INSURER A: OMIT® FIM AID CASUALTY CO
INSURER B: Plnnacol Assurance
INSURER C:
INSURER D:
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
N*K
LTRNSRN
WU
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDDIYY
PU RA ION
MI DATE MDD
LIMBS
A
X
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ® OCCUR
60-325-438
07/01/05
07/01/06
EACH OCCURRENCE
$ 1000000
PREMISES Eaoccurence
$ 100000
MED EXP(Any one person)
$ 5000
PERSONAL B ADV INJURY
$ 1000000
GENERAL AGGREGATE
$ 2000000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY 7 PROJECT LOC
PRODUCTS-COMP/OP AGG
$2000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
60-325-438
07/11/05
07/01/06
COMBINED SINGLE LIMB
(Es accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESSIUMBRELLA LIABILITY
OCCUR 17 CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
1788040
10/01/05
10/01/06
X TORY LIMITS ER
E.L. EACH ACCIDENT
$ 100000
E.L. DISEASE - EA EMPLOYEE
$ 100000
E.L. DISEASE - POLICY LIMIT
$ 500000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate holder is included as additional insured on the general
liability. r �
RE: Bid #5941-Buckingham Park Restrooms 2005DEC 21{„l.0
FAX 226-1802
CERTIFICATE HOLDER CANCELLATION
CITYFT5
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
City of Fort
Collins
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Purchasing &
Risk Management
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
215 N Mason St
Fort Collins
CO 80524
REPRESENTATIVES.
AU IZED REPRES
ACORD 25 (2001108) V ACURD GORFOR +I luN Taus